EXHIBIT G
CITY OF SAN BERNARDINO
COUNTY OF SAN BERNARDINO, STATE OF CALIFORNIA
COMMUNITY FACILITIES DISTRICT NO. 2019-1 (MAINTENANCE SERVICES) ANNEXATION NO. 28
(January 17, 2024)
This ballot is for the use of the authoriz ed representative of the following owner of land within Community Facilities District No. 2019-1 (Maintenance Services) (“CFD No. 2019-1”) of the City of San Bernardino:
Name of Landowner Number of Acres Owned Total Votes
Verdemont Ranch 20, LLC 24.83 25
According to the provisions of the Mello-Roos Community Facilities Act of 1982, and resolutions of the City Council (the “Council”) of the City of San Bernardino (the “City”), the above- named landowner is entitled to cast the number of votes shown above under the heading “Total Votes,” representing the total votes for the property owned by said landowner. The City has sent the enclosed ballot to you so that you may vote on whether or not to approve the special tax.
This
special tax ballot is for the use of the property owner of the parcels identified below, which parcels are located within the territory proposed to form the CFD No. 2019 -1, City of San Bernardino, County of San Bernardino, State of California. Please advise the City Clerk, at (909) 384-5002 if the name set forth below is incorrect or if you are no longer one of the owners of these parcels. This special tax ballot may be used to express either support for or opposition to the proposed special tax. To be counted, this special tax ballot must be signed below by the owner or, if the owner is not an individual, by an authorized representative of the owner. The ballot must then be delivered to the City Clerk, either by mail or in person, as follows:
Ma
il
Delivery:
Per
sonal
Delivery:
If by mail, place ballot in the return envelope provided, and mail no later than January 3, 2024, two calendar weeks prior to the date set for the election. Mailing later than this deadline creates the risk that the special tax ballot may not be received in time to be counted.
If in person, deliver to the City Clerk at any time up to 7:00 p.m. on January 17, 2024, at the Clerk’s office at 201 N. “E” Street, Bldg A, City of San Bernardino, CA 92401.
However delivered, this ballot must be received by the Clerk prior to the close of the public meeting on January 17, 2024.
Very truly yours,
Genoveva Rocha, CMC, City Clerk
TO
CAST THIS BALLOT, PLEASE RETURN THIS ENTIRE PAGE.
OFFICIAL SPECIAL TAX BALLOT
Name & Address of Property Owner: Assessor’s Parcel Number(s):
Verdemont Ranch 20, LLC
Attn: Felizardo Robles Jr.
434 N. 2nd Ave.
Upland, CA 91786
0348-111
-51
CITY OF SAN BERNARDINO
COUNTY OF SAN BERNARDINO, STATE OF CALIFORNIA
COMMUNITY FACILITIES DISTRICT NO. 2019-1 (MAINTENANCE SERVICES) AN “X” OR OTHER MARK WILL CAST ALL VOTES ASSIGNED TO THIS BALLOT SPECIAL TAX BALLOT MEASURE MARK “YES” OR “NO”
WITH AN “X”:
Shall the City Council of the City of San Bernardino be authorized to levy a special tax on an annual basis at the rates and apportioned as described in Exhibit C to the Resolution Declaring its Intention to Annex territory to Community Facilities District No. 2019-1 (Maintenance Services) adopted by the City Council on
December 6, 2023 (the “Resolution”), which is incorporated herein by this reference, within the territory identified on the map entitled “Annexation Map No. 28 of Community
Facilities District No. 2019-1 (Maintenance Services) City of San Bernardino” to finance certain services as set forth in Section 4 to the Resolution (including incidental
expenses), and shall an appropriation limit be established for the Community Facilities District No. 2019-1
(Maintenance Services) in the amount of spec ial taxes
collected?
YES _________
N
O _________
Certification for Special Election Ballot
The undersigned is an authorized representative of the above- named landowner and is the person legally authorized and entitled to cast this ballot on behalf of the above-named landowner.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on ____________, 20__.
Feli
zardo Robles Jr.
Manager
Signature
Print Name
Title